Subacute bacterial endocarditis of undetermined etiology

Enterococcal Endocarditis

“…cribed this in two cases; likewise, Loewe et al (1951), Wallach (1934), and Skinner and Edwards (1942) in four other cases. There was neither a rheumatic history nor clinical evidence of rheunatic heart disease in other cases reported by Guss (1948), Hein and Berg (1949), Dreher (1950), Merritt (1951), Loewe et al (1951), and Finn and Kane (1952)-seven in all. The enterococcal infection in Case 1 was superimposed on normal heart valves.…”

“…Other cases have been reported following urethral manipulation, cystoscopy, or prostatectomy, by Skinner and Edwards (1942), Hein and Berg (1949), Alexander (1950), Cates el al. (1951), Loewe et al (1951), Merritt (1951), Robbins and Tompsett (1951), and Finn and Kane (1952)-19 in all. Sirota et al (1947) found in 26 cases of enterococcal endocarditis at the Mount Sinai Hospital that " the source of infection was traceable in 10 cases to recent infection or operative manipulation of the genito-urinary tract, and in one to a septic criminal abortion."…”

“…Foci of suppuration may continually discharge organisms into the blood stream, thus necessitating prolonging the period of treatment. The actual endocarditis lesions are more of the ulcerative undermined .type than the exuberant, friable, thrombotic, cauliflowerlike masses of the viridans variety (Loewe et al, 1951).…”

“…Severe precordial pain may occur. Wallach (1934), Rantz and Kirby (1943), and Loewe et al (1951) have emphasized the frequency of focal suppurative lesions in the myocardium and in the organs peripheral to the heart. In consequence splenic rupture with fatal peritonitis has twice occurred.…”

“…Out of 31 cases of streptococcal subacute bacterial endocard'tis, Horder (1909) found that eight were due to Streptococcus faecalis, and Rantz and Kirby (1943) isolated this organism in 3 out of 16 cases of the disease. However, in large series Sirota et al (1947) and Loewe et al (1951) reported an incidence of the enterococcal variety of 3.2% and 3.8% respectively.…”